Kar­en Law has served as the ex­ec­ut­ive dir­ect­or of Pro-Choice Re­sources since Ju­ly 2008. Law has ded­ic­ated the ma­jor­ity of her ca­reer to an­ti­poverty and so­cial-justice work, help­ing fam­il­ies ac­cess the ba­sic re­sources and ser­vices they re­quire and de­serve. Law earned a bach­el­or’s de­gree in polit­ic­al sci­ence from the Uni­versity of Den­ver and lives in Min­nesota.

Law has spent the last few weeks fol­low­ing the Be Bold Road Trip across the coun­try with oth­er ad­voc­ates. The Be Bold Road Trip is co­ordin­ated by All* Above All, a co­ali­tion of more than 60 na­tion­al, state, and loc­al or­gan­iz­a­tions work­ing to re­store pub­lic in­sur­ance cov­er­age for abor­tion so that every wo­man, however much money she makes, can ac­cess af­ford­able, safe abor­tion care when needed.

Law shared her take on the state of abor­tion ac­cess with Na­tion­al Journ­al‘s Next Amer­ica pro­ject.

In the four dec­ades of leg­al, safe abor­tion, it has re­mained un­af­ford­able and un­avail­able for far too many. His­tor­ic­ally, wo­men who are strug­gling fin­an­cially have had a par­tic­u­larly dif­fi­cult time ac­cess­ing abor­tion care, mostly due to the ban on Medi­caid cov­er­age im­posed by the Hyde Amend­ment since 1976.

That was the ex­act in­ten­tion of law­makers when the ban was put in place.

“I cer­tainly would like to pre­vent, if I could leg­ally, any­body hav­ing an abor­tion, a rich wo­man, a middle-class wo­man, or a poor wo­man,” said Rep. Henry Hyde, R-Ill., at the time. “Un­for­tu­nately, the only vehicle avail­able is the [Medi­caid] bill.”

Hyde was par­tially suc­cess­ful in his mis­sion.

Ac­cord­ing to the Guttmach­er In­sti­tute, a re­pro­duct­ive-health policy and re­search or­gan­iz­a­tion, re­strict­ing Medi­caid cov­er­age of abor­tion forces one in four poor wo­men to carry an un­wanted preg­nancy to term. And their stud­ies show that low-in­come wo­men of­ten must get abor­tions later in preg­nancy and, as a res­ult, face great­er risk to their fin­an­cial well-be­ing.

“Re­search shows that poor wo­men who are able to raise the money needed for an abor­tion of­ten do so at great sac­ri­fice to them­selves and their fam­il­ies,” the Guttmach­er In­sti­tute found in a 2007 re­port. “Stud­ies in­dic­ate that many such wo­men are forced to di­vert money meant for rent, util­ity bills, food, or cloth­ing for them­selves and their chil­dren.”

Laws such as the Hyde Amend­ment do not simply cre­ate more bur­dens for low-in­come wo­men. They ap­pear to con­trib­ute to the cycle of poverty. A wo­man who seeks an abor­tion but is un­able to get one is three times more likely to fall in­to poverty than a wo­man who does, a 2012 study pub­lished by the Amer­ic­an Pub­lic Health As­so­ci­ation found.

Be­cause of the con­nec­tion between ra­cial dis­crim­in­a­tion and eco­nom­ic dis­ad­vant­age, this bur­den falls dis­pro­por­tion­ately on wo­men of col­or and young wo­men. Those with lower so­cioeco­nom­ic status—spe­cific­ally those who are least able to af­ford out-of-pock­et med­ic­al ex­penses—already ex­per­i­ence dis­pro­por­tion­ately high rates of ad­verse health. What I have heard on the Be Bold tour and what I have wit­nessed over the course of my ca­reer con­vinces me that cur­rent policies help to add to these bur­dens and un­justly in­crease the health and eco­nom­ic dis­par­it­ies wo­men of col­or face.

Ac­cord­ing to a 2012 re­port pro­duced by the Wo­men’s Found­a­tion of Min­nesota on the status of wo­men in Min­nesota—the state where I live and where my or­gan­iz­a­tion, Pro-Choice Re­sources, is loc­ated—there is a re­pro­duct­ive-rights crisis that dis­pro­por­tion­ately af­fects people of col­or. Teen preg­nancy in Min­nesota sits at a far high­er rate for teens of col­or than for white teens. House­holds headed by a wo­man of col­or are from 40 to 74 per­cent more likely to live un­der the poverty line and wo­men of col­or are un­in­sured at far high­er rates than their white peers.

Deny­ing ac­cess to abor­tion care only ex­acer­bates each of these prob­lems.

Part of our work at Pro-Choice Re­sources in­cludes as­sist­ing wo­men who want and need an abor­tion but that are un­able to af­ford this health care. Min­nesota law en­sures the leg­al right to abor­tion, and Min­nesota Med­ic­al As­sist­ance cov­ers abor­tion care. Yet, even with fa­vor­able laws in place, thou­sands of people in Min­nesota still find it nearly im­possible to ac­cess abor­tion care without a struggle.

The prob­lems as­so­ci­ated with ac­cess­ing abor­tion care grow even great­er out­side the Min­neapol­is/St. Paul metro area. More than 1.2 mil­lion people live in rur­al areas of the state. Yet, all but one of our state’s abor­tion pro­viders are loc­ated in the Twin Cit­ies. That situ­ation adds to the cost of an abor­tion. Rur­al wo­men have to shoulder any med­ic­al costs as­so­ci­ated with an abor­tion plus hous­ing, travel, time away from work, or child care for oth­er chil­dren, along with oth­er ex­penses.

All it takes is just one part of that net to un­ravel and the en­tire pro­cess falls apart. As one caller to the Pro-Choice Re­sources’ abor­tion fund re­cently ex­plained to one of my col­leagues, “It was scary think­ing I wouldn’t be able to get my abor­tion done be­cause I couldn’t af­ford a motel, then my rides to and from can­celed.”

Still, wo­men in Min­nesota rank among the more for­tu­nate. In more re­strict­ive states, laws pro­hib­it Medi­caid and in­sur­ance pur­chased through the Af­ford­able Care Act ex­changes from cov­er­ing abor­tion care. Ad­di­tion­ally, med­ic­ally un­ne­ces­sary clin­ic reg­u­la­tions have been passed de­signed spe­cific­ally to lim­it the num­ber of abor­tion pro­viders and abor­tion clin­ics avail­able.

Put this all to­geth­er and we have a situ­ation that has be­come dire.

For ex­ample, my or­gan­iz­a­tion in Min­nesota of­ten helps wo­men com­ing from South Dakota, where there is only one clin­ic loc­ated at the most south­east­ern corner of the state. Even if a wo­man is able to get there, South Dakota law re­quires a wo­man to wait 72 hours after an ini­tial ap­point­ment to have an abor­tion. This forces people to drive hun­dreds of miles on mul­tiple oc­ca­sions or go out­side the state for their abor­tion care.

At Pro-Choice Re­sources, we know firsthand that these re­stric­tions are mak­ing abor­tion more un­avail­able and un­af­ford­able. Every day, we hear from people who need abor­tion care and are strug­gling fin­an­cially. Some qual­i­fy for med­ic­al as­sist­ance but can­not get their in­come veri­fied be­cause the doc­u­ments they need are in a home they have fled be­cause of do­mest­ic vi­ol­ence. Oth­ers are young wo­men who are afraid to use their own in­sur­ance be­cause their par­ents will kick them out. We help wo­men who have no homes, and no one else to turn to in or­der to en­sure they have the same rights as any oth­er wo­man with more money or private, un­sub­sid­ized health in­sur­ance.

As one wo­man we as­sisted stated, “It’s im­port­ant to have these rights. It’s hard be­ing home­less, go­ing to school full-time and work­ing. Not hav­ing this op­tion is ludicrous, it should be every wo­man’s right.”

That’s why we are stand­ing up for all people and fam­il­ies, as part of the All* Above All Be Bold Road Trip. We be­lieve that wherever a wo­man lives, and however much she makes, every wo­man must be able to make her own de­cisions about preg­nancy. That should be true even if, and per­haps es­pe­cially if, a wo­man is already strug­gling.

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